期刊
EUROPEAN HEART JOURNAL
卷 34, 期 31, 页码 2472-2480出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/eht083
关键词
Implantable device diagnostics; Heart failure; Ambulatory monitoring; Risk; Hospitalization
资金
- National Institute for Health Research Biomedical Research Unit at the Royal Brompton Hospital, London
- Medtronic Inc.
We developed and validated a heart failure (HF) risk score combining daily measurements of multiple device-derived parameters. Heart failure patients from clinical studies with implantable devices were used to form two separate data sets. Daily HF scores were estimated by combining changes in intra-thoracic impedance, atrial fibrillation (AF) burden, rapid rate during AF, CRT pacing, ventricular tachycardia, night heart rate, heart rate variability, and activity using a Bayesian model. Simulated monthly follow-ups consisted of looking back at the maximum daily HF risk score in the preceding 30 days, categorizing the evaluation as high, medium, or low risk, and evaluating the occurrence of HF hospitalizations in the next 30 days. We used an AndersonGill model to compare survival free from HF events in the next 30 days based on risk groups. The development data set consisted of 921 patients with 9790 patient-months of data and 91 months with HF hospitalizations. The validation data set consisted of 1310 patients with 10 655 patient-months of data and 163 months with HF hospitalizations. In the validation data set, 10 of monthly evaluations in 34 of the patients were in the high-risk group. Monthly diagnostic evaluations in the high-risk group were 10 times (adjusted HR: 10.0; 95 CI: 6.415.7, P 0.001) more likely to have an HF hospitalization (event rate of 6.8) in the next 30 days compared with monthly evaluations in the low-risk group (event rate of 0.6). An HF score based on implantable device diagnostics can identify increased risk for HF hospitalization in the next 30 days.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据